SURGICAL MANAGEMENT OF COLONIC DIVERTICULITIS WITH FREE PERFORATION OR ABSCESS FORMATION

Both medical and economic considerations seem to point to the necessity of reappraisal of the traditional three stage method of treating diverticulitis with free perforation or gross abscess. Of the various alternatives, primary resection with anastomosis or primary excision with the proximal loop being brought out as a colostomy and closure or exteriorization of the distal loop seem the most attractive. The latter method combines the safety of the staged operations with the advantages of primary extirpation of the diseased bowel and seems to merit a more general trial. Primary resection and anastomosis without a concomitant colostomy, although undoubtedly applicable in specific instances, cannot yet be recommended for general use in these complicated cases. © 1969.